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Massachusetts must lower the barriers that prevent patients from accessing information and understanding who provides high-value care. Quality of care in the Commonwealth is among the best in the world, but it comes at a cost that is killing the middle class. Pioneer recommends that state leaders undertake the following approaches to monitor and ensure fair competition among drug companies: first, policymakers should obtain data on drug expenditure trends using multi-year, rebated data before considering policy changes that could affect drug development. Second, the Attorney General should aggressively enforce consumer protection and antitrust laws so as to minimize the abuse of patent and exclusivity protections. Finally, policymakers should delve more deeply into the potential impact of pricing opacity as a driver of overall healthcare cost inflation. here two important actions include advancing regulatory actions to enforce existing provisions in legislation to expand healthcare pricing transparency and promoting competition and embrace consumer tools like health savings accounts.